System for diagnosing musculoskeletal disorders

Abstract

A system for identifying muscular abnormalities in a human patient and diagnosing musculoskeletal disorders from the abnormalities includes collecting electromyographic signals from selected muscles of the patient while the patient undergoes a plurality of protocols, creating muscle activity samples from the electromyographic signals collected from the patient, defining one of more indices by algebraically combining selected muscle activity samples, calculating the index of the patient from the selected group of collected samples, and comparing the index to a normative range of values for the index to determine whether the patient has a muscular abnormality and to diagnose the abnormality. The system is employed to identify dysfunctional psychophysiological and biomechanical muscle patterns in the upper quarter and forearm of the patient.

I claim: 
     
       1. A method for identifying muscular abnormalities of a human patient, the method comprising the steps of: (a) selecting at least one protocol from a series of protocols based on physiological information from the patient;   (b) collecting muscle activity samples from one or more muscles of the patient while the patient performs the selected protocol;   (c) defining at least one index from a selected group of the collected samples by algebraically combining a plurality of specified muscle activity samples or by algebraically combining a plurality of ratios of specified muscle activity samples;   (d) calculating the index from the selected group of collected samples; and   (e) comparing the calculated index to a normative range of values for the index to determine whether the index calculated for the patient is abnormal.   
     
     
       2. A method according to claim 1 wherein the protocol performed in step (b) includes: (i) placing the patient in a defined position,   (ii) instructing the patient to undergo one or more maneuvers while in the position, and   (iii) collecting a plurality of muscle activity samples as the patient undergoes the maneuvers.   
     
     
       3. The method according to claim 2 wherein the muscular abnormalities to be identified are in the upper quarter and forearm of the patient. 
     
     
       4. A method according to claim 3 wherein step (b) (i) includes having the patient sit, arms resting in the lap, the maneuvers performed in step (b) (ii) include a first non-specific instruction period followed by a shoulder shrug period and a shoulder relaxation period, and   step (b) (iii) includes collecting a first set of data points from the upper and lower trapezius during the first period, and a second set of data points from the upper and lower trapezius during the shoulder relaxation period.   
     
     
       5. A method according to claim 3 wherein step (b) (i) includes having the patient stand, arms resting by the side, the maneuvers performed in step (b) (ii) include a first non-specific instruction period followed by a shoulder shrug period and a shoulder relaxation period, and   step (b) (iii) includes collecting a first set of data points from the upper and lower trapezius during the first period, and a second set of data points from the upper and lower trapezius during the relaxation period.   
     
     
       6. A method according to claim 3 wherein step (b) (i) includes having the patient sit in a chair, arms resting in the lap, the maneuvers performed in step (b) (ii) include, sequentially, a first non-specific instruction period, an abduction maneuver and an arm relaxation period, and   step (b) (iii) includes collecting a first set of data points from the upper and lower trapezius during the first period, a second set of data points from the upper and lower trapezius after completion of the abduction maneuver, a set of peak amplitudes from the upper and lower trapezius during the abduction maneuver, and a set of total muscle activity values from the upper and lower trapezius during the abduction maneuver.   
     
     
       7. A method according to claim 3 wherein step (b) (i) includes having the patient stand, arms resting by the side, the maneuvers performed in step (b) (ii) include, sequentially, a first non-specific instruction period, an abduction maneuver and an arm relaxation period, and   step (b) (iii) includes collecting a first set of data points from the upper and lower trapezius during the first period, a second set of data points from the upper and lower trapezius after completion of the abduction maneuver, a set of peak amplitudes from the upper and lower trapezius during the abduction maneuver, and a set of total muscle activity values from the upper and lower trapezius during the abduction maneuver.   
     
     
       8. A method according to claim 3 wherein step (b) (i) includes having the patient stand, arms resting by the side, the maneuvers performed in step (b) (ii) include a first period of normal respiration followed by a plurality of deep inspirations with the mouth closed, and   step (b) (iii) includes collecting a first set of data points from the upper trapezius and scalene muscle prior to the first period, a second set of data points from the upper trapezius and scalene muscle after completion of the plurality of deep inspirations, a set of peak amplitudes from the upper trapezius and scalene muscle during each of the plurality of deep inspirations, and a set of total muscle activity values from the upper trapezius and scalene muscle during each of the plurality of deep inspirations.   
     
     
       9. A method according to claim 3 wherein step (b) (i) includes having the patient sit, arms resting in the lap, the maneuvers performed in step (b) (ii) include, sequentially, a first period of time where the head is in a neutral position, a rotation of the head as far to one side as is possible without experiencing pain, a holding of the head position for a second period of time followed by a return of the head to the neutral position, a rotation of the head as far to the other side as is possible without experiencing pain, a holding of the head position for a third period of time followed by a return of the head to the neutral position, and   step (b) (iii) includes collecting a first set of data points from the upper trapezius and sternocleidomastoid during the first period and shortly prior to the first head rotation, a second set of data points from the upper trapezius and sternocleidomastoid after completion of the second head rotation, a set of peak amplitudes from the upper trapezius and sternocleidomastoid during each of the head rotations, and a set of total muscle activity values from the upper trapezius and sternocleidomastoid during each of the head rotations.   
     
     
       10. A method according to claim 3 wherein step (b) (i) includes having the patient sit, arms resting in the lap, the maneuvers performed in step (b) (ii) include, sequentially, a first period of time where the head is in a neutral position, a rotation of the head as far to one side as is comfortably possible without experiencing pain, a holding of the head in the maximally rotated position for a second period of time followed by a return of the head to the neutral position, a rotation of the head as far to the other side as is comfortably possible without experiencing pain, a holding of the head in the maximally rotated position for a third period of time followed by a return of the head to the neutral position, and   step (b) (iii) includes collecting a first set of data points from the upper trapezius and sternocleidomastoid during the first period and shortly prior to the first head rotation, a second set of data points from the upper trapezius and sternocleidomastoid after completion of the second head rotation, a set of peak amplitudes from the upper trapezius and sternocleidomastoid during each of the head rotations, a set of total muscle activity values from the upper trapezius and sternocleidomastoid during each of the head rotations, a set of total muscle activity values from the extensor and flexor surfaces of the forearm, and a set of time-linked muscle activity values from the upper trapezius, sternocleidomastoid and extensor and flexor surfaces of the forearm at the onset and completion of each of the head rotations.   
     
     
       11. A method according to claim 3 wherein step (b) (i) includes having the patient stand, arms resting by the side, the maneuvers performed in step (b) (ii) include, sequentially, a first period of time where the head is in a neutral position, a rotation of the head as far to one side as is comfortably possible without experiencing pain, a holding of the head in the maximally rotated position for a second period of time followed by a return of the head to the neutral position, a rotation of the head as far to the other side as is comfortably possible without experiencing pain, a holding of the head in the maximally rotated position for a third period of time followed by a return of the head to the neutral position, and   step (b) (iii) includes collecting a first set of data points from the upper trapezius and sternocleidomastoid during the first period and shortly prior to the first head rotation, a second set of data points from the upper trapezius and sternocleidomastoid after completion of the second head rotation, a set of peak amplitudes from the upper trapezius and sternocleidomastoid during each of the head rotations, a set of total muscle activity values from the upper trapezius and sternocleidomastoid during each of the head rotations, a set of total muscle activity values from the extensor and flexor surfaces of the forearm, and a set of time-linked muscle activity values from the upper trapezius, sternocleidomastoid and extensor and flexor surfaces of the forearm at the onset and completion of each of the head rotations.   
     
     
       12. A method according to claim 3 wherein step (b) (i) includes having the patient stand, arms resting by the side, the maneuvers performed in step (b) (ii) include, sequentially, a first non-specific instruction time period where the wrist is in a neutral position, an extension of the wrist as far as is comfortably possible without experiencing pain, a holding of the wrist in the maximally extended position for a second period of time followed by a return of the wrist to the neutral position, a second period of time where the wrist is held in the neutral position, a flexing of the wrist as far as is comfortably possible without experiencing pain, and holding of the wrist position for a third period of time in the maximally flexed position followed by a return of the wrist to the neutral position, and   step (b) (iii) include collecting a first set of data points from the extensor and flexor surfaces of the forearm during the first period and shortly prior to the wrist extension, a second set of data points from the extensor and flexor surfaces after completion of the wrist flexion, a set of peak amplitudes from the extensor and flexor surfaces during the wrist extension and flexion, and a set of total muscle activity values from the extensor and flexor surfaces during the wrist extension and flexion.   
     
     
       13. A method according to claim 3 wherein the index is selected from the group comprising a psychophysiological index, a biomechanical index and a forearm index. 
     
     
       14. A method according to claim 3 wherein the index is related to a muscle selected from the group comprising the trapezius, scalene, sternocleidomastoid, extensor digitorum and flexor digitorum superficialis. 
     
     
       15. A method according to claim 1 wherein step (b) comprises collecting samples from a plurality of muscles, and the index is defined by the plurality of muscles. 
     
     
       16. A method according to claim 15 wherein the muscles are selected from the group comprising the trapezius, scalene, sternocleidomastoid, extensor digitorum and flexor digitorum superficialis. 
     
     
       17. A method according to claim 1 wherein the protocol performed in step (b) includes a plurality of patient actions selected from the group consisting of non-specific instruction periods, deliberate movements, relaxation periods and rest periods. 
     
     
       18. A method for determining dysfunctional psychophysiological muscle patterns in a patient comprising the steps of: (a) collecting muscle activity samples from one or more muscles of the patient while the patient undergoes one or more protocols;   (b) defining at least one psychophysiological index from a selected group of the collected samples by algebraically combining a plurality of specified muscle activity samples or by algebraically combining a plurality of ratios of specified muscle activity samples;   (c) calculating the psychophysiological index from the selected group of the collected samples; and   (d) comparing the calculated psychophysiological index to a normative range of values for the index to determine whether the index calculated from the patient is abnormal, thereby indicating a psychophysiological dysfunction in the patient.   
     
     
       19. A method according to claim 18 wherein the protocol in step (a) includes performing a plurality of patient actions including movements, relaxation periods and rest periods. 
     
     
       20. A method according to claim 18 wherein the muscle activity samples are selected from the group comprising data points, peak amplitudes, total muscle activity and time linked muscle activity. 
     
     
       21. A method according to claim 18 wherein step (a) comprises collecting the samples with a multichannel surface electromyography device. 
     
     
       22. A method for determining dysfunctional biomechanical muscle patterns in a patient comprising the steps of: (a) collecting muscle activity samples from one or more muscles while the patient undergoes one or more protocols;   (b) defining at least one biomechanical index from a selected group of the collected samples by algebraically combining a plurality of specified muscle activity samples;   (c) calculating the biomechanical index from the selected group of the collected samples; and   (d) comparing the calculated biomechanical index to a normative range of values for the index to determine whether the index calculated from the patient is abnormal, thereby indicating a biomechanical dysfunction in the patient.